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The effects of recreational drugs on CD4 and CD8 T cells in humans are not well understood. We conducted a longitudinal analysis of men who have sex with men (MSM) enrolled in the Multicenter AIDS Cohort Study (MACS) to define associations between self-reported use of marijuana, cocaine, poppers and amphetamines, and CD4 and CD8 T cell parameters in both HIV-uninfected and HIV-infected MSM. For the HIV-infected MSM, we used clinical and laboratory data collected semiannually before 1996 to avoid potential effects of antiretroviral treatment. A regression model that allowed random intercepts and slopes as well as autoregressive covariance structure for within subject errors was used. Potential confounders adjusted for included length of follow-up, demographics, tobacco smoking, alcohol use, risky sexual behaviors, history of sexually transmitted infections, and antiviral therapy. We found no clinically meaningful associations between use of marijuana, cocaine, poppers, or amphetamines and CD4 and CD8 T cell counts, percentages, or rates of change in either HIV-uninfected or -infected men. The regression coefficients were of minimum magnitude despite some reaching statistical significance. No threshold effect was detected for frequent (at least weekly) or continuous substance use in the previous year. These results indicate that use of these substances does not adversely affect the numbers and percentages of circulating CD4 or CD8 T cells in either HIV-uninfected or -infected MSM.

self-reported use of marijuana, cocaine, poppers and amphetaminesif we could trust self-reported use of marijuana, cocaine, poppers and amphetaminesthen there would not be random drug tests in work placesalsothe horrible before and after pictures of meth users, is that caused by cheerios or captain crunch?there is a flaw in this studyit must be the self-reported use of marijuana, cocaine, poppers and amphetamineshow many addicts report anything accuratelyi have heard many of them say crazy things about hiv and they were sober at the time at the hiv clinicphilly i appreciate the post and i wish or hope it is true and anyone is free to do whatever they wantbut the devastating effects of cocaine, poppers and amphetamines on many men at least on west coast is undeniableif you ask fat people and got the self reported eating of cakes cookies and sugar there may not be a collelationlets say that 100% of addicts lie ormeth users lieormeth users lie about the amount of meth they usewhat about all the gay meth users in So Cal that killed themselves or are in mental institutionsdid the dr's go interview them?honestly when i read this i was amazed and felt perhaps it is truebut i know personally if i miss one good nights sleep since poz i am wiped out i will say thissome people have super strong systems and it doesn't seem to matter how hard they party and use drugsand these guys may have reported good resultsbut for me personally i choose to say away from those drugsfinallythere are 43,000 people a year in USA catching HIV and 19,000 dying every year of aids in 2006most of those dying have had the disease a long timedoes this mean that this study suggests that even if one takes good care of oneselfstill the t cells fall and even on haart the t cells fall eventuallyi am legitimately asking this questioncan this study be true?

There are other parts of the immune system that were not assessed. In 1987, Dax assessed the impact of poppers use on the human immune system. She found that natural killer cell function was the factor most affected. That effect was temporary, but it took 4 days for the natural killer cell function to return to baseline. In addition, the amount of sniffs was low/moderate. Its unknown if more sniffs would result in great suppression of natural killer cell function or that it might last longer. Additional research may answer this question.

Natural killer cells have a role in initial defense against infections. If someone is already HIV positive, getting infected may not be an issue. However, it may be for their HIV negative, or HIV status unknown partners.

And if everyone used protection during anal sex , then the risk of infection disappears. However, significant numbers of guys are having unprotected anal sex. Thus, the import of raising the issue of poppers use temporarily suppressing immune system defense and increasing susceptibility to infection....if exposed.

Recent epidemiology research finds that poppers use increases the likelihood of HIV infection during unprotected anal sex. There are multiple reasons that explain the risk with immune suppression being one. All the factors could be operating in which case poppers use poses a compound risk for HIV infection.

Participants in the 2007 Terrence Higgins Trust focus group on poppers expressed a desire to know if poppers affected the immune system. Another human study assessing the effect of poppers use on the immune system might add clarity to the issue. To date there is just the two Dax human studies. Subsequent studies have been mice, rat, or cell cultures.

Recent epidemiology research finds that poppers use increases the likelihood of HIV infection during unprotected anal sex. There are multiple reasons that explain the risk with immune suppression being one. All the factors could be operating in which case poppers use poses a compound risk for HIV infection.

Not so (although that is how you would love us to read that research).

That research (Macdonald N et al. Factors associated with HIV seroconversion in gay men in England at the start of the 21st century) said that the theory that poppers could increase biological susceptibility to infection was plausible, but highly improbable.

.. which is your cue to start pimping a certain website that is full of bizarre and largely discredited, outlandish and unsupported claims .. and our cue to tell you that those bizarre and largely now even more discredited, outlandish and unsupported claims amount to nothing more than a pile of crap.

There is virtually no robust evidence that poppers cause any sort of immune suppression .. and, in November 2007, according to the Terrence Higgins Trust (who you seem to love quoting):

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There is research suggesting poppers have no lasting significant effect on the human immune system, and certainly no conclusive research shows any significant impact on human immunity.

Participants in the 2007 Terrence Higgins Trust focus group on poppers expressed a desire to know if poppers affected the immune system.

The exact statement was:

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Men wanted certainty or precision, often where this is difficult or impossible, eg, around the scale of increase in risk or how much and for how long poppers might cause immune suppression

... which isn't quite the same.

The same focus group also felt:

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Some suspected health promoters are using Ďscare storiesí about poppers to further an agenda

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Men might give up poppers believing this would make unprotected sex of negligible risk

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Men are suspicious of uncertainty couched in terms of Ďmightí or Ďcouldí, and felt if health promoters do not know or are dealing in a theory they should stick to concrete facts and/or clearly state they are not sure

There is an absence of robust evidence for poppers weakening the immune system. The great majority of studies involve animal, not human subjects, and much of this research is open to criticism for poor methodology. In studies suggesting a negative impact on immunity, there appears to be a modest suppression of CD4 cells (in mice) or natural killer cells (in humans) for 4-7 days following poppers use. However, many factors affect immune function or CD4 count, including diet, exercise, smoking and time of day.

Many of the research studies investigating the impact of poppers on immunity come with caveats or methodological flaws such as:

ē studies may be conducted on blood cell cultures in the test tube, not in live subjectsē studies frequently involve rodents (some genetically altered to have no immune defences), not humansē adjustments are often not made for the difference in body mass between rodents and humansē quantity and duration of exposure to poppers can be much greater than typical in recreational useē poppers may be injected into the bloodstream, not inhaledē study samples are usually smallē study results may include preliminary, unconfirmed data or findings not obtained in repeated trialsē data is not published in respected peer-reviewed medical journals.

There is research suggesting poppers have no lasting significant effect on the human immune system,and certainly no conclusive research shows any significant impact on human immunity. In fact, inhaled nitrites break down easily and quickly leave the body.

.. the same Lisa Ringold who I seem to remember a certain Hank Wilson dismissing as an irrelevance in these very forums .. although not, it seems, as irrelevant as Hank Wilson himself, because he only got a mention by through the title of her critical review

The report also labours the point that false links between poppers causing AIDS and KS are good examples of how people and poor science have in the past concluded causal links between one thing and another when there was in fact none.

The report also rubbishes the claim (put about by a Hank Wilson and others) that the use of poppers causes risky sexual behavior:

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The disinhibiting effect of poppers is unlikely to be the explanation for greater HIV transmission seen in poppers users in these studies. Many other drugs with similar or stronger disinhibiting effects often do not emerge as significant risk factors in these studies. Several studies have found no association between poppers use and non-condom use.

.. and:

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Simply because two behaviours occur together (eg, using poppers and becoming HIV positive) does not mean one causes the other. Poppers use may just be a marker of another behaviour or factor that is more relevant to the infection such as (unprotected) anal sex, rough sex, use of other drugs, STI acquisition or a generally less healthy lifestyle.

The Terence Higgins Trust report on poppers is unfortunately unbalanced and parrots Lisa Ringold's criticisms of the research. Some of Ringold's allegations are untrue, while others overstate the limitations cited. I agree with some of the criticisms but its not like Hank Wilson controls the funding or protocol decisions of research. Ringold makes no critique of popper industry claims or practices. THT also fails to disclose that Ringold's critique is from a poppers industry website.

I respond to Lisa Ringold's criticisms at www.poppers.cfsites.org .( Go to LINKS and then to the bottom where I respond to Ringold point by point). some of the criticisms are directed at the research itself and some is directed at my efforts to date. My response to Ringold is a work in progress which I intend to modify.

There is also a link to Seattles 2006 online survey of gay men about poppers. Like the THT focus group feedback, Seattle respondents also want to know more about poppers. No message can be a message. Given a lack of certainty, what should the message be? There should be some reference to the published research and perspective(s) about it. I see no problem in acknowledging the limitations of research. THT missed an opportunity to present a more balanced perspective about what we know and what we want to know. That said, it is progress that the issue of poppers affecting the immune system is getting attention.

Sure, Hank .. so, earlier you were happy to misrepresent the THT report (just as you are happy to misrepresent pseudo-science and bad science as good peer reviewed science) when you thought you could get away with it, but now it is unbalanced and parrots Lisa Ringold's criticisms of the fake Ďresearchí you rely on

Let's face it, you would only think it was "balanced" if it came down in favour of your wacko extremism.

PS: THT discloses exactly where Lisa Ringoldís criticisms are from - it even provides the url - so yet again you choose to misrepresent FACTS.

The big question for me is what motivates Hank to continually misrepresent these facts. What's he getting out of it? And mind you, this is not a new hobby for him -- it's evidently been going on for 25 years.

The big question for me is what motivates Hank to continually misrepresent these facts. What's he getting out of it? And mind you, this is not a new hobby for him -- it's evidently been going on for 25 years.

Other people enjoying something that he doesnít enjoy?

It may be the poppers .. it may be something that people tend to do when they use poppers.

It could just be that he still needs to cling on to the belief that poppers are to blame for him being HIV-positive.

The sad fact is that what grains of truth there are in his twisted propaganda - and I do actually think there are a few - get lost, because so much of what he has said is demonstrably untrue and unbelieveable.

It is like being asked to buy a car from someone who has already sold you two lemons. No-one in their right mind is going to do it.

From the published research: "Although the circulating numbers of CD4 and CD8 T cells do not appear to be significantly affected by use of these substances, these findings do not preclude the possibility that substance use may adversely affect the functional properties of T cells."

In the Dax human studies (published 1988, 1991) assessing the impact of poppers use on the human immune system, it was not the numbers of natural killer cells, but natural killer cell function that was most affected.

Although the circulating numbers of CD4 and CD8 T cells do not appear to be significantly affected by use of these substances, these findings do not preclude the possibility that substance use may adversely affect the functional properties of T cells.

Those findings don't preclude the possibility that dinosaur piloted meteors may affect adversely the functional properites of T cells either Hank.

So, by your own admission, poppers donít appear to significantly affect the number of circulating CD4 and CD8 cells; but, as almost anyone who goes for regular bloods will tell you: diet, exercise, smoking / giving up smoking, time of day, how much sleep you had (or didnít have), having a weekend binge and a whole host of other common daily factors most certainly do .. yet you are still obsessed with the seemingly insignificant effect of poppers?

Are you sure this doesnít have more to do with the fact that you just donít have the big brass balls to admit that you have been so consistently and hideously WRONG about almost everything you have said about poppers since you started the absurd witch hunt, back in 1981? .. when you were just as certain that poppers caused AIDS.